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Sensemaking / Tracking obesity in Asia: one size does not fit all

An obesity epidemic could be about to happen in Asia – and businesses and government are unprepared

A new report released by the World Health Organisation has presented worrying statistics on child obesity around the world. In Asia, the ‘obesity epidemic’ may be more advanced and spreading more rapidly than first appears. The reason why this has gone unnoticed for such a long time could be to do with the metrics we use to measure BMI (Body Mass Index). In the West, individuals are classified as obese when they have a BMI of more than 30. The BMI is calculated by squaring the ratio of body weight to height.

When this metric is applied it initially appears that South East Asia is the least obese region in the world. However, the BMI metric doesn’t take body fat into consideration. The Asian population generally has more body fat on the same physical frame. When compared to a European of the same BMI, an Asian person may have between three and five percent higher total body fat.1

This discrepancy could have serious implications. Within Asia, incidence of obesity could be much higher that what is currently being diagnosed, and people at high risk of serious obesity related illnesses could fall through the net. Furthermore, metrics like BMI are used not only to identify and measure obesity within a population, but also as an indicator of susceptibility to serious health risks and likelihood of contracting related non-communicable diseases, such as heart disease and diabetes.

At the moment half of the people in the world with diabetes are in Asia. The Asian population may have up to double the risk of developing type 2 diabetes as white Europeans2 and is also affected by diabetes at a younger age. Other studies suggest the Asian population also has a higher risk of hypertension and cardiovascular disease and a higher risk of related death.

Governments use metrics such as BMI to set priorities and design budgets for the public health system. The way the metrics are currently used could result in governments underestimating the risk to health of this sector of the population. In the long term, governments will be unprepared for the social and economic costs of poor nutrition.

Even without considering the BMI inaccuracy, the growth of obesity in Asia is worrying. Obesity growth rates between 2010 and 2014 were often double those for the US and UK and reached a high of 38 percent in Vietnam.3

So, what can be done to stop this growing crisis?

For Asian populations, it might be more accurate to classify as obese the population with a BMI higher than 23. Another potential solution is a tax on sugary drinks. The ‘soda sin tax’ is becoming increasingly popular across the world as a tool in the fight against obesity. India, Indonesia and the Philippines are all looking into their own soda sin tax, making global beverage companies anxious about how this regulation will affect their profits in some of the world’s fastest growing consumer markets. But would it work in Asia?

Let’s take Singapore as an example: only ten percent of Singaporeans’ calories come from sugary drinks - more than half is from condensed milk and other sugars found in tea and coffee (the sweetness of local coffee and tea is a surprise to a European or American palette). At the same time, white rice accounts for over half of caloric intake. So, while a soda sin tax might work in Singapore, increasing the availability and consumption of brown rice as opposed to white rice would probably have a greater impact. And, this is a conclusion we could draw across most of Asia, where rice, and particularly white rice, forms the major staple of the everyday diet.

And what will all this mean for business? Some of the world’s fastest growing consumer markets are in Asia. Businesses should be aware that in the future they will need to consider adapting for changing diets as obesity becomes a more serious issue. Partnering with governments, NGOs and other organisations to contribute to the growing body of knowledge on Asian diets is potentially a great way to start.

Gwyneth Fries, a Senior Sustainability Advisor at Forum for the Future participated in the 2ndannual meeting of the Asia Roundtable on Food Innovation for Improved Nutrition (ARoFIIN), jointly supported by the Singapore Health Promotion Board, Singapore’s Institute for Clinical Sciences and Food Industry Asia. Nutrition scientists, policy makers and industry representatives shared insights supporting the need for a regional approach to nutrition security, and particularly to combating obesity.

Sources:

Deurenberg P, Deurenberg-Yap M, Guricci S. Asians are different from Caucasians and from each other in their body mass index/body fat percent relationship. Obes Rev. 2002;3:141-6.